By Adam Pagnucco.

Governor Larry Hogan may be silent on the efforts by President Donald Trump and congressional Republicans to gut health care, but his newly appointed Chair of the Maryland Health Care Commission has been anything but silent.  To the contrary, Hogan’s new point man on health care has openly advocated for the destruction of the Affordable Care Act.

Robert E. Moffit, whom Hogan appointed Chair of the Maryland Health Care Commission on May 9, will now be playing a critical role in administering Maryland’s health care system.  The commission is an independent agency with broad regulatory powers over health care providers in areas including IT, data reporting, performance evaluations, certificates of need authorizing new hospitals and expansions and much more.  Moffit’s appointment would normally be confirmed by the Maryland State Senate, but since they do not return to Annapolis until next year, Moffit will have plenty of time to make his mark on the state’s health care system.

And that could be quite a mark.  During his tenure as Senior Fellow at the Heritage Foundation, Moffit was a leading critic of the ACA, which provides health coverage to more than 400,000 Marylanders, and called for it to be repealed as soon as possible.  Consider his views.

1.  In one of many screeds against the ACA, Moffit said it was experiencing “multi-organ failure” and that “central planning is the disease.”  One wonders what he thinks about other “centrally planned” health care systems like Medicare and the Veterans Health Administration.

2.  Moffit wrote that Congress “should kill the employer mandate entirely,” thus leaving employees to fend for themselves in health care as they did before the ACA was passed.

3.  Moffit enthusiastically endorsed the GOP’s plan to issue waivers to states so that they could excuse insurers from having to cover pre-existing conditions.  In an article entitled “House Health Care Bill Moving in the Right Direction,” he wrote, “President Barack Obama and his allies in Congress should never have imposed centralized federal control over diverse state health insurance markets in the first place.  While the best solution would be to repeal that federal overreach, the proposed waiver is a significant improvement over current law. Its practical effect is to achieve a devolution of health insurance rulemaking back to the states.”

4.  Just weeks after Hogan appointed him, Moffit cheered on Trump’s budget, which called for $800 billion in cuts to Medicaid and converting it into a block grant program.  Moffit wrote: “By putting Medicaid on a budget—either through a fixed allotment to the states in the form of a block grant or a per capita cap—the Trump budget would give state officials much needed flexibility in managing the program and better target services to the poorest and most vulnerable of our citizens.”

5.  Last November, when criticizing the ACA’s poll numbers, Moffit wrote, “What ‘progressive’ politicians want, and their academic and media cheerleaders like, most Americans don’t want or like.”  According to Gallup, the ACA’s approval rating went from 42% at the time Moffit wrote his article to 55% in April.  Apparently, Americans want to have health care after all.

6.  Moffit called the Republican House bill replacing the ACA “a major improvement over current law.”  Yesterday, the Congressional Budget Office found that the House bill would increase the number of Americans without health coverage by 23 million by 2026.  The office said, “Premiums would vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums.”

In selecting Moffit, Governor Hogan has broken his silence on the Affordable Care Act.  Moffit’s views are longstanding, well developed and very public.  If Hogan had major disagreements with him on the ACA, why would he appoint him to one of the most powerful health care positions in Maryland?  Actions speak louder than words, and this action speaks volumes.